Stephen Crum
Physician Assistant in Woodburn, OR. Individual provider (NPI-1).
NPI number1194228551
StatusActive
Last updated in NPPESMar 17, 2021
Details
- NPI
- 1194228551
- Entity type
- Individual (NPI-1)
- Name
- Stephen Crum
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 13, 2018
- Certification date
- Mar 17, 2021
- Last updated
- Mar 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 187343 | OR | Yes |
Practice location
1175 Mount Hood AveWoodburn, OR 97071
Phone 503-982-2000
Mailing address
1175 Mount Hood AveWoodburn, OR 97071-9060
Phone 503-982-2000 · Fax 503-982-0660
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